BEVERLY CLARKE (NPI# 1376182659) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376182659 |
| Entity Type | Individual |
| Full Name | BEVERLY CLARKE |
| Practice Address |
2247 Colston St Petersburg VA 23805-2203 |
| Mailing Address |
2400 Oaklawn Blvd Trlr 13 Hopewell VA 23860-5045 |
| Practice Telephone | 7659776296 |
| Mailing Telephone | 8042473528 |
| Enumeration Date | 2020-01-03 |
| Last Update Date | 2020-01-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3747A0650X |
Technician Specialization: Attendant Care Provider |
VA | Nursing Service Related Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477726404 | Beverly Mae Clarke | Counselor | 181 Union St Ste B, Lynn, MA 01901-1310 | 2008-04-10 |
| 1871771840 | Beverly Jean Clarke | Registered Nurse | 1671 W Grant Rd, Tucson, AZ 85745-1433 | 2008-02-01 |
| 1407941214 | Beverly Simpler Clarke | Nurse Practitioner | 100 Brown St, Chestertown, MD 21620-1435 | 2006-10-04 |
| Street Address |
2247 COLSTON ST |
| City | PETERSBURG |
| State | VA |
| Zip Code | 23805-2203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134690647 | Miles Viant | Occupational Therapist | 287 E Blvd, Petersburg, VA 23805 | 2018-12-10 |
| 1245756964 | Dexter Shabazz Lett | Registered Nurse | 10543 S. Crater Rd, S. Prince George, VA 23805 | 2017-08-15 |
| 1891145876 | Taylor Enhanced Living | Counselor | 105 Holly Hill Dive, Suite A, Petersburg, VA 23805 | 2016-06-21 |
| 1700255205 | Ina Thompson | Counselor | 272 Medical Park Boulevard, Petersburg, VA 23805 | 2015-09-15 |
| 1932582541 | Valeria Edda Madrid Malo Bohorquez | Internal Medicine | 50 Medical Park Blvd Ste C, Petersburg, VA 23805 | 2015-06-30 |
| 1548642788 | Justin Andrew Phillingane | Podiatrist | 3335 S Crater Rd Ste 500, Petersburg, VA 23805 | 2015-06-24 |
| 1225417082 | Paladin Dermatology LLC | Nurse Practitioner | 44 A& B Medical Park Blvd, Petersburg, VA 23805 | 2015-05-27 |
| 1245652544 | Family Services Inc. | Health Maintenance Organization | 1045 Gustavo Lane, Petersburg, VA 23805 | 2014-01-06 |
| 1619268075 | Charlene Belangia | Massage Therapist | 3323 S. Crater Rd, Suite B, Petersburg, VA 23805 | 2011-04-20 |
| 1760709638 | Caresouth Hha Holdings of Virginia, LLC | Home Health | 34 Medical Park Boulevard, Suite G-h, Petersburg, VA 23805 | 2010-04-30 |
| Find all providers in zip 23805 | ||||
| Taxonomy Code | 3747A0650X |
| Grouping | Nursing Service Related Providers |
| Classification | Technician |
| Specialization | Attendant Care Provider |
| An individual who provides hands-on care, of both a supportive and health related nature, specific to the needs of a medically stable, physically handicapped individual. Supportive services are those that substitute for the absence, loss, diminution, or impairment of a physical or cognitive function. This service may include skilled or nursing care to the extent permitted by state law. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508471426 | Tyrric Mason | Technician | 633 W Washington St, Petersburg, VA 23803-4132 | 2020-09-09 |
| 1316584618 | Crystal Eldridge | Technician | 1326 Halifax St, Petersburg, VA 23803-5919 | 2019-12-05 |
| 1487297289 | Iris Taylor | Technician | 1525 Baxter Rd, Petersburg, VA 23803-7901 | 2019-10-24 |
| 1760091821 | Lisa Shaffer | Technician | 12 Maple Hill Ave Ste 1, Petersburg, WV 26847-1547 | 2020-07-24 |
| 1427667575 | Rebekah Swick | Technician | 12 Maple Hill Ave Ste 1, Petersburg, WV 26847-1547 | 2020-07-24 |
| 1174132229 | Robin Berry | Technician | 12 Maple Hill Ave, Petersburg, WV 26847-1547 | 2020-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548868540 | Charly Strickland | Technician | 305 Wakefield Dr, Locust Grove, VA 22508-5135 | 2020-10-12 |
| 1174120315 | Martha Coffield | Technician | 2400 Sarah Spence, Williamsburg, VA 23185-8060 | 2020-10-01 |
| 1700493822 | Albert Herdeg | Technician | 319 Wood Duck Ct, Suffolk, VA 23434-8096 | 2020-09-24 |
| 1639784952 | Denise Quarantello | Technician | 4927 Fenton Mill Rd, Williamsburg, VA 23188-6923 | 2020-09-14 |
| 1407469653 | Gwenolyn Murphy | Technician | 25460 Meherrin Rd, Capron, VA 23829-2050 | 2020-08-27 |
| 1386253730 | Natosha Hurt | Technician | 27728 Prince Edward Hwy, Rice, VA 23966-2702 | 2020-07-30 |
| 1336757772 | Jaye Hughes | Technician | 5116 Hunters Meadow Pl, Henrico, VA 23231-7668 | 2020-07-22 |
| 1477161107 | Susie Shell | Technician | 154 Baltic Dr, Weber City, VA 24290-7324 | 2020-07-20 |
| 1245857838 | Latifat Adegite | Technician | 10805 Three Chopt Rd, Henrico, VA 23233-2019 | 2020-06-29 |
| 1205452257 | Barbara Pollard | Technician | 5658 High St W, Portsmouth, VA 23703-3742 | 2020-06-24 |
| Find all providers with the same taxonomy | ||||
| City | PETERSBURG |
| Zip Code | 23805 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.